In a series of 375 patients with anterior cervical fusions, long-term follow-up results complete with laryngeal examination were obtained in 102 patients. One patient was found to have an inferior laryngeal nerve palsy, and one had a superior laryngeal nerve palsy. Both deficits were thought to be the result of surgical trauma. Measures to minimize the incidence of vocal cord paralysis include careful surgical technique and knowledge of the surgical anatomy of the laryngeal nerves. Suggestions are given for the assessment of postoperative hoarseness, and for the management of vocal cord paralysis.

Primary small cell carcinoma of the nose and paranasal sinuses is rare. This tumor appears to behave differently from the pulmonary small cell tumor, with propensity for local recurrence rather than early distant spread. Two new cases will be presented.SMALL cell carcinoma arising in the nasal cavity and paranasal sinuses is very rare. Although references to highly undifferentiated and anaplastic carcinoma have appeared in the literature, the designation of small cell carcinoma of the nasal tract did not appear until 1972. Several additional cases have since been reported. Although these tumors were histologically identical to the small cell carcinoma arising in the lung, review of the literature suggests a different clincial behavior for these tumors arising in the nose and sinuses, with a propensity for local recurrence rather than early metastatic spread. This necessitaties a different treatment approach, using surgical extirpation of the lesion in conjunction with chemotherapy and radiotherapy. We have treated two such patients. CASE REPORTSCase 1.-A 54-year-old man was evaluated for intermittent epistaxis. Results of the initial examination were normal. Shortly after that, nasal obstruction and proptosis developed. A granular area was noted on the left middle turbinate. Decreased sensation was noted along the first and second divisions of the fifth cranial nerve. Medial and lateral gaze was restricted. Pupillary responses were normal. Admission

Although nasal polyposis is a common entity, it is seldom considered a cause of bony destruction with consequent ophthalmologic and neurologic sequelae. Acute bilateral visual loss developed suddenly in a young, healthy woman with nasal polyps. Evaluation revealed erosion of the floor of the anterior cranial fossa, with compression of the optic nerves secondary to extensive paranasal and nasal polyposis. The clinical course, treatment, and histopathologic findings are discussed.